Veterinary Practice News Evidence-based Medicine Column

Last summer, I was asked to take over the Evidence-based Medicine Column (previous the Alternative Medicine Column) in the trade magazine Veterinary Practice News from Dr. Narda Robinson. This was an excellent opportunity to illustrate the principles and techniques of evidence-based medicine in action, evaluating specific medical practices and discussing general issues related to EBM. Some of these columns will cover alternative therapies, but many focus on conventional medical therapies as well, since I have always advocated evaluating all therapies by the same, science-based standards. I will keep a running collection of links to these columns here as each becomes available to the public, as well as occasionally posting those with content that hasn’t appeared here before. Enjoy!

It stands for “certificate in Veterinary Medical Acupuncture.” Since I am quite skeptical of acupuncture and critical of many of the claims made about it, I elected to take a certification course run by Dr. Narda Robinson at CSU so that I could honestly say I had thoroughly and fairly considered the arguments and and evidence presented by defenders of the practice. I blogged the experience of the course here, and while it didn’t do much to change my views on the subject, it was an interesting exploration of a controversial topic.

I noticed Veterinary Practice News pulled the controversial online Dr Poll article written by a lawyer. I thought it was well written and very informative. Probably their most important article with maybe the exception of your articles. Good luck.

If you read the article, you will note that I specifically said I wasn’t going to talk about risks and benefits of spaying in general because 1200 words is barely enough space to talk about the evidence regarding the differences between the specific procedures. I have addressed the debates about whether and when to spay in detail elsewhere. For example:

A good prospective randomized study would be take litters of lab pups. Spay 1/3 of them Leave 1/3 of them intact and start 1/3 of them on Cheque drops (mibolerone) and follow them out. My guess is there might already be prospective randomized trials that compare spay vs Cheque drops that were done just before upjohn almost released this drug in dog food thirty years ago. I tried to find such studies on the internet with no luck. Who ever owns Upjohn now might have them if they exist. Since most animals, human nurses included,
seem to live longer with their ovaries it would be interesting to see the results of these studies

human doctors thought a few years back human ovaries should go also.
seehttps://www.nytimes.com/2009/04/28/health/research/28ovar.html
Now that there are no male stray dogs sitting in your front yard when your dog comes in heat the reason most of my clients want their dog spayed is to avoid blood on the bed sheets twice a year. In most of the free world, except the usa, vets have a shot they can give dogs to keep them out of heat. If studys have been done to see what’s safer spay or the shot(suprelorin) I have not seen them. Suprelorin for dogs have been coming soon to the usa for over a decade. Not sure of the politics behind that. The reason given why the fda would not allow mibolerone in the dog food was because a study showed a lot of humans eating dog food.

I find it both terrifying that an ever-growing segment of the population automatically considers anyone who calls themselves a “skeptic” to be negative, suspect, evil, hostile to them personally (as opposed to unwilling to instantly swallow whole whatever their particular cherished belief) or any combo of the above. If the goal of education in the last several decades was to encourage critical thinking, it has failed dismally.

Then we have online definitions such as: “Sometimes people are skeptical just because they don’t believe something, in spite of scientific evidence.” I wouldn’t call such people skeptical, I’d call them anti-skeptical –determined to hang on to beliefs despite proof to the contrary.

Or a site that apparently explains: “why people are negative, pessimistic and skeptical,” which again paints skeptics as bad.

I prefer (credited to Steven Novella): “A skeptic is one who prefers beliefs and conclusions that are reliable and valid to ones that are comforting or convenient, and therefore rigorously and openly applies the methods of science and reason to all empirical claims, especially their own.”

Why are people so scared of evidence-based ideas? I’m having to get a new physician (mine retired) and was startled to see in one bio that the doc “favors evidence-based medicine.” The fact that a physician finds it necessary to spell this out is appalling, though I assume it weeds out those who would waste his time seeking homeopathy, de-toxing, “cleansing,” and all the other ludicrous snake oils of today. I’ve spent my life in science, as a vocation & avocation, and cannot understand why so many are determined to navigate the realities of life using utter nonsense as their guides. Or why they become deranged when someone tries to provide a some evidence-based facts. Makes me despair of the future…and the near present, for that matter.